Background:
Although concerns have been raised about the effect of the hospitalist model on the doctor–patient relationship, hospitalists now care for many hospitalized patients. How hospitalists explain their role may influence patients’ perception of the hospitalist.
Methods:
To characterize how hospitalists describe their role to patients, we performed a qualitative analysis of audio‐recorded admission encounters between attending hospitalists and their patients at 2 hospitals within a university system. First, a codebook was developed using an iterative process to identify passages in which hospitalists described, directly or indirectly, their and other providers’ involvement in patient care. To test the reliability of the codebook, 2 coders used it to independently code a 20% subset of encounters; kappa was 0.77, indicating substantial agreement. A single coder coded the remaining transcripts. We then performed a secondary analysis of all identified passages and the patients’ responses to them to identify descriptive categories and overarching themes.
Results:
Audio‐recordings of 80 patients’ encounters with 27 hospitalists were analyzed. All encounters contained some description by the hospitalist of his/her role in the patient's care. Five categories were identified within the descriptions; these categories and text exemplars are shown in Table 1. Across and within these categories, hospitalists’ descriptions of their involvement in patient care varied widely. For example, some described their primary responsibility as checking labs, whereas others described coordinating all the patient's inpatient and follow‐up care. Hospitalists negotiated with patients about patients’ expectations of their role, such as when the patient was seen by providers, who would coordinate aspects of care, and who would provide information.
TABLE 1 Categories of Hospitalist Descriptions of Their Role in Patient Care and Text Exemplars
Conclusions:
In admission encounters, hospitalists frequently described their role in patient care. Although all participating physicians shared the same position and responsibilities, how they described their role to patients varied widely. How hospitalists describe themselves may have a significant impact on how patients understand the hospitalist's role as well as their trust in the hospitalist. Future research should explore patient perceptions of hospitalists’ descriptions and develop clear and consistent language for hospitalists to describe their role.
Disclosures:
F. Reiff‐Pasarew ‐ none; J. E. W. Cimino ‐ none; W. G. Anderson, none